July 27

A closure of colostomy in a 40 years old male  (loop colostomy done in April for impalement rectal injury). The colostomy was dismembered and reanastomosed.

July 30

An obese lalaji from Samana with obstructed PUH, recurred after repair at Samana one year back.

The small gut loops were found to be grossly distended and dusky with several patches of discoloration at many places. This recovered after decompression and covering with warm packs. Mesh repair was done thereafter. The postoperative Ileus persisted for 4 days.

July 31

Laparotomy for a large mass in the right lumbar region in a young 18 years old female (c/o Dr Bhagwant Singh). Barium study had shown the colon to be clear and the patient had no bowel symptoms as such. However, at surgery, the big mass looked like arising from the right colon and infiltrating into an adherent loop of upper jejunum. Both the mass and the involved jejunal loop were excised along with the right colon in an extended right hemicolectomy. Posteriorly in the retroperitoneum the mass was adherent with the head of the pancreas, and was shaved off from there. On cut section the large irregular ulcerated  mass of colon was found to have invaded into the loop of jejunum too. Biopsy later reported adenocarcinoma of colon. Referred for chemotherapy.

Aug 3

1. Laparotomy (Surjit Kaur: Dr Kaler’s patient): Excised the recurred right ovarian mass, when CA 125 showed a rise last week (previously had a big ovarian tumour excised 2 yeas back, and later had had chemotherapy for ovarian cancer at AIIMS, Delhi).

2. An ileocecal mass with multiple strictures (TB) and adherent gut loops in the pelvis in a 16 years old female on ATT. All excised with difficulty; ending with an ileocolic anastomosis.